Overactive Thyroid: Causes, Symptoms, and Treatment Complications of Hyperthyroidism Hyperthyroidism is a disorder in which your thyroid gland makes and releases more thyroid hormone than your body needs. Your doctor may say you have an " overactive thyroid ," or refer to the condition as "overactive thyroid disease." Your thyroid gland is located in the front of your neck. Hormones released by the thyroid affect nearly every part of your body from your brain to your skin and muscles. They play a crucial role in controlling how your body uses energy, a process called metabolism . This includes how your heart beats and even how you burn calories. Women are five to 10 times more likely to develop hyperthyroidism than men. Causes of Hyperthyroidism The causes of hyperthyroidism include: Graves' disease . The most common cause of hyperthyroidism is an autoimmune condition called Graves' disease. The body's immune system creates an antibody that causes the gland to make an excessive amount of thyroid hormone. Graves' disease runs in families, and usually affects younger women. Thyroiditis. Thyroiditis is inflammation of the thyroid.

A virus or problem with the immune system causes the gland to swell, leaking thyroid hormone into the bloodstream. There are several types of thyroiditis. Subacute: A sudden, painful form of thyroiditis of unknown cause. The thyroid usually heals on its own after a few months. The thyroid can become underactive for a while before it returns to normal. Postpartum: This type of thyroiditis affects women after pregnancy . One to two women out of every 10 women develop hyperthyroidism after having a baby . It usually lasts a month or two, followed by several months of underactive thyroid ( hypothyroidism ). In most women, the thyroid returns to normal. Silent: This type is similar to postpartum thyroiditis but is not related to pregnancy. The thyroid produces too much hormone but patients do not develop a painful thyroid gland. Some people may develop hypothyroidism afterwards. Thyroid nodule . One or more lumps, or nodules, can grow in the thyroid gland, gradually increasing the gland's activity and the amount of thyroid hormone in your blood . If one nodule causes hyperthyroidism, it is called a single toxic nodule.

If several nodules cause the thyroid to become overactive, the condition is called toxic multinodular goiter . Continued Excess iodine. You may also develop hyperthyroidism if you eat, drink, or are otherwise exposed to substances that contain a high amount of iodine. Iodine is used by the body to make thyroid hormone. Kelp or seaweed supplements and the medication amiodarone ( Cordarone , Pacerone ), once used to treat irregular heartbeats, are examples of medicines that contain a lot of iodine. Thyroid medications . Taking too much thyroid hormone medication can wreak havoc on your thyroid gland and cause hyperthyroidism. If you have been prescribed thyroid replacement hormone (for hypothyroidism ), never take an extra dose, even if you missed one, without first talking to your doctor. Symptoms of Hyperthyroidism Symptoms of hyperthyroidism may be vague and can often mimic other illnesses and conditions. If you have a very mild form of hyperthyroidism, you may not notice any symptoms. Symptoms are often particularly subtle in the elderly. However, an overactive thyroid often leads to discomfort or even disability that disrupts your everyday activities or routines.

Thyroid enlargement, called a goiter, occurs in most people with hyperthyroidism. You may see or feel a lump in the front of your neck. Sometimes only your doctor will be able to detect a goiter. Other symptoms of hyperthyroidism include: Anxiety , nervousness, and irritability Radioactive iodine uptake test to see your thyroid’s absorption of iodine Thyroid scan to see where iodine is in the thyroid Continued How Is Hyperthyroidism Treated? There are several different ways to treat hyperthyroidism. Before choosing the one that's best for you, your doctor will consider your age, overall heath, severity of your symptoms, and specific cause of your overactive thyroid. Treatment options include: Anti-thyroid drugs. These medications, including propylthiouracil (PTU) and methimazole ( Tapazole ), help prevent the thyroid gland from making new hormone. This doesn't permanently damage the thyroid, but some people may have serious side effects. Radioactive iodine (RAI) taken by mouth . Overactive thyroid cells quickly absorb this iodine and soon die. This prevents the release of thyroid hormone. Any remaining radioactive iodine disappears from the body within a few days.

It may take a few months for the therapy to relieve hyperthyroidism symptoms, and a second dose may be needed. People who have this treatment will develop an underactive thyroid ( hypothyroidism ), and will need thyroid hormone supplements for the rest of their life. This therapy cannot be done during pregnancy. Surgery to remove all or part of the thyroid, called a thyroidectomy. Most people who have this procedure eventually develop an underactive thyroid and will need to take thyroid hormone-replacement medication for the rest of their life. Beta-blockers to slow down your heart rate . These medicines do not lower your thyroid hormone levels but help relieve symptoms related to a rapid heart rate. After treatment, you will need regular blood tests to check your thyroid hormone levels. Your doctor may need to adjust your medication dose from time to time. Complications of Hyperthyroidism It is important to maintain regular, lifelong visits with your doctor if you have hyperthyroidism. Untreated or improperly treated, an overactive thyroid can lead to severe, even life-threatening problems.

Complications linked to hyperthyroidism include: Hyperthyroidism, Overactive Thyroid, & Graves' Disease Hyperthyroidism, Overactive Thyroid, & Graves' Disease Search the site By Mary Shomon - Reviewed by a board-certified physician. Updated August 11, 2016 Hyperthyroidism occurs when your thyroid gland produces too much thyroid hormone. It is sometimes also referred to as an "overactive” thyroid or, by the medical term, thyrotoxicosis. When functioning normally, your thyroid—a small, butterfly-shaped gland in your neck—uses dietary iodine to produce thyroid hormone. The purpose of thyroid hormone is to regulate how your organs, glands, tissues, and cells use oxygen and energy. The human body needs thyroid hormone in order to survive and function, but it needs to be the right amount. What Are the Causes of Hyperthyroidism? There are a number of health issues and conditions that result in a thyroid that overproduces thyroid hormone. Autoimmune Graves’ Disease This is the most common cause of hyperthyroidism.

Graves' disease is an autoimmune disease where your immune system inappropriately produces antibodies, known as thyroid stimulating antibodies (TSI), that overstimulate your thyroid gland and cause it to overproduce thyroid hormone. There are phases of Hashimoto’s disease where the thyroid gland can cause temporary hyperthyroidism. Iodine-Excess Hyperthyroidism Iodine overexposure/overconsumption can trigger or cause hyperthyroidism. Sources of iodine include iodine-based contrast tests and high doses of iodine supplementation, including iodine-rich herbs like bladderwrack and kelp. Overdosage of Prescription Thyroid Hormone If you take too much thyroid medication, by accident or intentionally, this can cause what's known as factitious hyperthyroidism. If your doctor prescribes a dosage that is too high, that results in iatrogenic hyperthyroidism. Drug- and Supplement-Induced Hyperthyroidism A number of drugs have been shown to cause hyperthyroidism. Some of the more well-known ones include interferon, dopamine, bromocriptine, high-dose steroids, and amphetamines.

There are also supplements, especially some over-the-counter thyroid support supplements , that can cause hyperthyroidism. In violation of regulations, some over-the-counter supplements have been found to contain actual thyroid hormone. Other supplements that can potentially trigger hyperthyroidism include iodine, kelp, and bladderwrack. Hyperfunctioning Thyroid Nodules/ Toxic Multinodular Disease Thyroid nodules can sometimes become capable of producing thyroid hormone, apart from the hormone being produced by the gland itself. In some cases, these nodules produce too much thyroid hormone, causing hyperthyroidism. In a condition known as toxic multinodular disease, multiple nodules produce thyroid hormone and cause hyperthyroidism. Transient Hyperthyroidism of Hyperemesis Gravidarum Transient hyperthyroidism of hyperemesis gravidarum, or THHG, is a form of hyperthyroidism triggered by a severe morning sickness during pregnancy. Exams and Tests to Diagnose Graves' Disease and Hyperthyroidism Thyroiditis Some of the various types thyroiditis cause periods of hyperthyroidism. Postpartum thyroiditis, in particular, frequently starts with a hyperthyroid phase.

Pituitary-Induced Hyperthyroidism The thyroid gland can become overstimulated and produce excessive amounts of thyroid hormone as a result of a malfunctioning and overactive pituitary gland. Neonatal Hyperthyroidism Neonatal hyperthyroidism is a type of hyperthyroidism in a newborn that is a result of elevated maternal thyroid stimulating immunoglobulin levels during pregnancy that cause the baby to be born with excess thyroid antibodies in their own system. What Are the Risk Factors for Hyperthyroidism? There are a number of risk factors for hyperthyroidism, but gender is perhaps the most important. Being a woman means you are eight to 10 times more likely than a man to develop a thyroid condition. And while women are at a much higher risk of hyperthyroidism than men, there are some additional points where that risk is even greater for women, including: During puberty When you are currently pregnant When you've had a child within the past year When you are in perimenopause When you are past menopause Age: While hyperthyroidism can occur at any age, it is more common as you get older; in particular, it is more likely to occur after age 40.

Thyroid History: If you or family members have a history of any thyroid disease, especially goiter, nodules, or thyroiditis, this increases your risk of hyperthyroidism. Autoimmune History: If you or family members have other autoimmune diseases—even if they are not autoimmune thyroid diseases like Graves’ disease and Hashimoto’s thyroiditis—you are at greater risk of developing hyperthyroidism. Other Risk Factors: Other risk factors include the following: Iodine excess (i.e. from supplementing with iodine or iodine-rich supplements) Being a past or current smoker Medications: Taking certain medications like interferon, dopamine, bromocriptine, high-dose steroids, and amphetamines Hyperpituitarism: An over functioning pituitary gland (typically due to a benign tumor called an adenoma) What Are the Signs and Symptoms of Hyperthyroidism? Clinical Signs There are some observable signs of hyperthyroidism that can be measured, seen, or detected in a clinical examination by your practitioner.

Some of these signs of hyperthyroidism include: Goiter - the medical term for an enlarged thyroid gland that can be seen or felt A visible or palpable lump in the area of your thyroid/neck Evidence of increased blood flow to your thyroid, which your doctor can hear by stethoscope A high heart rate, high blood pressure, higher-than-normal body temperature, heart palpitations, or changes in heart rhythm Fast or hyperresponsive reflexes Some other common hyperthyroidism symptoms you may experience include: Fatigue, exhaustion, sluggishness, even after sufficient sleep Insomnia, anxiety, panicky feelings Feeling hot when others are cold, sweating more than usual, feeling unusually thirsty Hoarse or gravelly voice Aches, pains, or weakness in your joints, hands, and feet These lists, however, are just the tip of the iceberg. For a full overview of possible symptoms, as well as some that are unique to women, babies, and children, read our in-depth review: Symptoms and Signs of a Thyroid Condition . How Is Hyperthyroidism Diagnosed? A Clinical Examination During a clinical examination, your doctor should evaluate your personal and family history for thyroid and autoimmune disease, review your symptoms, and examine your thyroid manually.

The doctor will also look for other clinical signs of hyperthyroidism, including a high pulse rate, high blood pressure, heart palpitations, changes to hair and skin texture, goiter (an enlarged thyroid), exaggerated reflexes, bulging eyes, and patchy skin on your legs, among others. Blood Testing Blood tests are used to diagnose hyperthyroidism. These tests include: Thyroid Stimulating Hormone (TSH) : When your thyroid is producing too much thyroid hormone, the TSH level drops. When you are hyperthyroid, this level will usually be below the reference range; if you are significantly hyperthyroid, it will be close to 0. Free Thyroxine (Free T4): Your doctor should also evaluate your free T4, the unbound available form of this thyroid hormone. In hyperthyroidism, these levels will typically be in the high end of the reference range, or above the top cutoff of the range. Free Triiodothyronine (Free T3): Your doctor should also measure your free T3 to get a picture of the unbound circulating levels of this active thyroid hormone.

In hyperthyroidism, these levels will typically be in the high end of the reference range, or above the top cutoff of the range. Thyroid Antibodies Testing: To determine if your hyperthyroidism is due to autoimmune disease, your doctor should also conduct antibodies testing, specifically, the thyroid stimulating immunoglobulin (TSI) levels. Elevated TSI can be indicative of Graves’ disease. Some doctors also test for elevated thyroid peroxidase antibodies (TPO) and thyroglobulin antibodies (TgAb), which, in some cases, may help pinpoint whether the hyperthyroidism is a temporary phase of Hashimoto’s disease. Imaging Tests There are a number of imaging tests that can be done to further evaluate your thyroid function. But the test most often used as part of the process of diagnosing hyperthyroidism is the specialized radioactive iodine uptake (RAI-U) test. In this test, a small dose of radioactive iodine is administered, and a follow-up scan can detect whether the thyroid—or nodules within the thyroid—is overproducing thyroid hormone.

If you are hyperthyroid, your gland usually takes up higher amounts of iodine than normal, and that uptake is visible in an elevated result on the RAI-U test. A thyroid that takes up iodine is referred to as "hot" or overactive, versus a "cold" or underactive thyroid. If you have Graves' disease, the RAI-U will be elevated and show that your entire gland is hot. If you have thyroid nodules, RAI-U will show whether the nodules are hot and are producing thyroid hormone. If you are hyperthyroid due to a hot nodule, and not Graves' disease, the nodule will show up as hot, and the rest of your thyroid will be cold. Hot nodules may overproduce thyroid hormone but they are rarely cancerous. In someone with hyperthyroidism, the RAI-U would typically be normal only if hyperthyroidism is due to a pituitary tumor or taking too much thyroid medication. How Is Hyperthyroidism Treated? There are three key treatments for chronic hyperthyroidism and Grave's disease .

Antithyroid Drug Treatment Antithyroid drugs help to regulate thyroid levels by making it more difficult for the body to use iodine to produce thyroid hormone or, in some cases, to block the conversion of T4 to T3. The preferred antithyroid drug in the Unite States is methimazole, which is also known by its brand name, Tapazole. (Carbimazole is a drug that metabolizes into methimazole and is known by its brand name Neo-Mercazole. It is more commonly used in Europe.) Propylthiouracil is usually abbreviated as PTU. There are no brand names of PTU in the United States, as only generic PTU is available. PTU inhibits the thyroid from using iodine to produce thyroid hormone and inhibits T4-to-T3 conversion. Due to some risks associated with PTU, methimazole is most often recommended, except during the first trimester of pregnancy, when methimazole is associated with risks of birth defects. Among the antithyroid drugs, methimazole is considered the first-line drug in most cases. This is because PTU has a higher risk of liver damage.

PTU is recommended only in patients who have an allergy to methimazole (and during the first trimester of pregnancy.) If you are on PTU, your doctor should closely watch you for signs and symptoms of liver problems, especially during the first six months after initiation of therapy. All the antithyroid drugs can have some side effects, including rashes, itching, and hives. Some people may have this reaction to one of the drugs, but not have side effects with another drug. If symptoms are significant, you may not be a good candidate to continue with antithyroid drugs. There is a rare but serious side effect of antithyroid drugs, called agranulocytosis. This makes it hard for your body to produce enough white blood cells, which lowers your immunity and makes you more likely to get infections. If you develop a fever or a sore throat while taking antithyroid medications, it's crucial that you consult your doctor immediately to rule out agranulocytosis. In some cases, antithyroid drugs will allow you to achieve a remission of your hyperthyroidism. This means that thyroid levels return to the reference range and symptoms disappear.

Your doctor may taper you off the antithyroid drugs. Keep in mind, however, that even after a remission, your hyperthyroidism may return, so periodic monitoring is important. Beta Blockers Beta blockers are not a stand-alone treatment for hyperthyroidism, but they are sometimes prescribed along with antithyroid drugs–or before or after RAI or thyroid surgery–to help relieve symptoms, including rapid heart rate, heart palpitations, and tremors. Common beta blockers include Inderal (propranolol), Tenormin (atenolol), and Lopressor and Toprol-XL (metoprolol), among others. Radioactive Iodine Treatment In the United States, radioactive iodine (RAI) is a common treatment for most people with Graves' disease and hyperthyroidism. Some other terms sometimes used to describe RAI include radioiodine ablation; radioactive iodine ablation; thyroid ablation; and ablation therapy. RAI is given as a single dose, in a capsule or drink, where it enters the thyroid, radiates thyroid cells, and damages and kills them. This shrinks the thyroid, slows down its function, and reverses hyperthyroidism.

While the goal of RAI is to leave enough of the thyroid to have the gland function normally and produce normal levels of thyroid hormone, there are cases where the dose of RAI is not enough or is too much. When the dose was too low, you may continue to have hyperthyroid symptoms and, ultimately, may require a second RAI treatment. When the dose is too high, which is common, your thyroid will be left in a situation where it is unable to produce enough thyroid hormone. This means that you are now considered hypothyroid and will likely require lifelong thyroid hormone replacement drugs. It’s also important to note that if you are planning to conceive, doctors recommend waiting for six months to a year after RAI before getting pregnant. If you want to have a baby more quickly, you may want to discuss the option of surgery with your doctor. Many doctors in the United States emphasize RAI as the first—and sometimes the only—option for the treatment of hyperthyroidism. Keep in mind that outside the United States, long-term use of antithyroid drugs and surgery are considered equally valid options, so be sure to explore all of the options with your doctor.

It’s also important to make sure that you are not rushed into RAI with hyperthyroidism that is temporary or transient, such as with Hashimoto’s disease or a postpartum thyroiditis. Be sure that your doctor is knowledgeable, has explained the cause of your hyperthyroidism, ruled out any transient/temporary hyperthyroidism, and is clear about why RAI is being recommended over other treatment options. Thyroid Surgery/Thyroidectomy Thyroid surgery is performed in some cases as a treatment for Graves’ disease and hyperthyroidism, especially if you cannot tolerate antithyroid drugs, or you want to get pregnant in the next year. Also, if you develop significant hyperthyroidism during pregnancy and cannot tolerate antithyroid drugs—or you require such high doses that the baby is being affected—surgery may be recommended, which is usually performed during your second trimester. Surgery is considered very effective and can provide rapid relief of symptoms to most patients, particularly when you have a large goiter and/or severe symptoms. Thyroidectomy to remove all or part of the thyroid gland is considered a safe surgery, as it has a low rate of complications when done by an experienced surgeon.

Integrative/Functional Approaches to Hyperthyroidism On the medical side, some cutting-edge, integrative practitioners are using low-dose naltrexone (LDN), a safe, generic, and inexpensive drug, to lower antibodies. In addition, some physicians are using a new approach, autologous stem cell transplants, to help reduce antibodies and "reboot" the immune system. Integrative physicians, traditional Chinese medicine (TCM) practitioners, and naturopaths also offer some other approaches to address both the underlying autoimmunity that causes many cases of hyperthyroidism and the overactivity of the thyroid itself. Some of the herbs and supplements used to deal with autoimmune Graves' disease and hyperthyroidism include selenium, bugleweed, l-carnitine, Royal maca, valerian, ashwagandha, lemon balm, and B-complex. In many cases, these herbs and supplements do not replace your need for antithyroid drugs, but allow for lower—and therefore safer—doses of these drugs to be used.

Active stress management is also highly recommended by many integrative practitioners to help calm heart- and blood pressure-related symptoms, as well as improve anxiety and nervousness that accompany hyperthyroidism. Active stress management approaches that may work include guided meditation, breath work, gentle yoga, Tai Chi, Qi Gong, or crafts like needlework, painting, or coloring. A word of caution: Untreated hyperthyroidism increases the risk for a dangerous condition known as thyroid storm, which can cause uncontrolled high blood pressure and heart rate, and lead to a stroke or heart attack. If you choose to work with a holistic or integrative practitioner on natural approaches, make sure it is someone who is highly reputable and knowledgeable about working with hyperthyroid patients. It also goes without saying that because of the risk, you should never consider hyperthyroidism a “do-it-yourself” project and attempt to treat yourself with over-the-counter herbs or supplements. A Healthy Life After Hyperthyroidism Treatment The permanent treatments for hyperthyroidism—RAI and surgery—usually result in you being hypothyroid, meaning that you will require lifelong thyroid hormone replacement drugs.

It’s important, then, to be prepared by becoming knowledgeable about thyroid hormone replacement treatment and how to ensure that your treatment is optimal, not just designed to get your levels into the reference range while failing to relieve hypothyroidism symptoms. A good starting point is reading the many hypothyroidism-related articles here at Verywell that can help you live well. You may want to start with: Hyperthyroidism Overview - Overactive thyroid makes too much thyroid hormone Hyperthyroidism Overview Written by Grazia Aleppo MD, FACE, FACP Hyperthyroidism is a condition in which the thyroid gland is overactive and makes excessive amounts of thyroid hormone. The thyroid gland is an organ located in the front of your neck and releases hormones that control your metabolism (the way your body uses energy), breathing, heart rate, nervous system, weight, body temperature, and many other functions in the body. When the thyroid gland is overactive (hyperthyroidism) the body’s processes speed up and you may experience nervousness, anxiety, rapid heartbeat, hand tremor, excessive sweating, weight loss, and sleep problems, among other symptoms.

Thyroid Gland (red) Hyperthyroidism has a number of causes and, fortunately, a number of treatment options. It is important you talk to your doctor if you think you may have symptoms of hyperthyroidism. Symptoms The symptoms of hyperthyroidism include the following: fatigue or muscle weakness heart palpitations or irregular heartbeat skin dryness increased frequency of bowel movements light periods or skipping periods. Some people may develop a goiter, which is an enlarged thyroid gland that feels like a swelling in the front of your neck. See more hyperthyroidism symptoms . Causes of Hyperthyroidism The thyroid gland makes the hormones thyroxine (T4) and triiodothyronine (T3) that play an important role in the way your whole body functions. If your thyroid gland makes too much T4 and T3, this is defined as hyperthyroidism. The most common cause of hyperthyroidism is the autoimmune disorder Graves’ disease. In this disorder, the body makes an antibody (a protein produced by the body to protect against a virus or bacteria) called thyroid-stimulating immunoglobulin (TSI) that causes the thyroid gland to make too much thyroid hormone.

Graves’ disease runs in families and is more commonly found in women. Hyperthyroidism also may be caused by a toxic nodular or multinodular goiter, which are lumps or nodules in the thyroid gland that cause the thyroid to produce excessive amounts of thyroid hormones. In addition, inflammation of the thyroid gland—called thyroiditis—resulting from a virus or a problem with the immune system may temporarily cause symptoms of hyperthyroidism. Furthermore, some people who consume too much iodine (either from foods or supplements) or who take medications containing iodine (such as amiodarone) may cause the thyroid gland to overproduce thyroid hormones. Finally, some women may develop hyperthyroidism during pregnancy or in the first year after giving birth. Diagnosis Hyperthyroidism is diagnosed based on symptoms, physical exam, and blood tests to measure levels of thyroid stimulating hormone (TSH) and thyroid hormones T3 and T4. Your doctor may also decide to order either an ultrasound or a nuclear medicine scan of your thyroid to see if it has nodules, or whether it is inflamed or overactive.

Treatment of Hyperthyroidism Hyperthyroidism can be treated with antithyroid medications that interfere with the production of thyroid hormones (primarily methimazole; propylthiouracil is now used only for women in the first trimester of pregnancy). Another option is radioactive iodine therapy to damage the cells that make thyroid hormones. In rare cases in which women do not respond to or have side effects from these therapies, surgery to remove the thyroid (either one part of the entire gland) may be necessary. The choice of treatment will depend on the severity and underlying cause of your symptoms, your age, whether you are pregnant, other conditions you may have, and the potential side effects of the medication. In addition to these treatments, your doctor may also prescribe beta-blockers to block the effects of thyroid hormones on your body. For example, beta-blockers help slow down a rapid heart rate and reduce hand tremors. Updated on: 01/03/17 American Thyroid Association. Hyperthyroidism. June 2012. Available at: Accessed April 7, 2014. Mayo Clinic. Hyperthyroidism (overactive thyroid). November 2012.

Available at: Accessed April 7, 2014. National Endocrine and Metabolic Diseases Information Service. Hyperthyroidism. July 2012. NIH Publication No. 12–5415. Accessed April 7, 2014. You May Also Like: Graves' Disease: Causes, Symptoms and Treatment Graves' Disease: Causes, Symptoms and Treatment By Alina Bradford, Live Science Contributor | December 12, 2014 10:47pm ET MORE Credit: Alexander Raths | shutterstock Graves' disease is an autoimmune disorder where misplaced attacks from the immune system cause the thyroid gland to become overactive. The result, known as hyperthyroidism, causes the thyroid to produce an excessive amount of the thyroid hormone, thyroxine. Too much thyroxine can affect every area of the body, including metabolism, brain development, heart and nervous system functions, body temperature, muscle strength, menstrual cycles, weight and cholesterol levels. Graves' disease is very common and affects about 1 in 200 people and is the most common cause of hyperthyroidism in the United States, according to the National Institutes of Health (NIH).

Graves' disease it is most often seen in women ages 20 to 40. Symptoms Since hyperthyroidism can manifest itself in the form of goiter, in addition to other symptoms caused by metabolic disruptions, physical examination may find swelling around the neck. Patients could also have an increased heart rate, according to the National Library of Medicine (NLM). Some patients could also experience Graves' opthalmopathy, where their eyelids retract and eyes budge from their sockets. This condition affects between 25 and 50 percent of people with Graves disease, according to NIH . Other symptoms include, anxiety, erectile problems, weight loss, heat sensitivity, changes in menstrual cycles, tremors and frequent bowel movements. Those with urinary problems may need to be checked for Graves', too. "From perspective of an urologist, thyroid disease is an important cause of urological symptoms in men and women. Graves disease in particular can present early on with urinary symptoms such as frequent urination and slow urine stream,"Dr. Alex Shteynshlyuger, director of urology at New York Urology Specialists, told Live Science. These symptoms usually clear up once Graves' has been treated.

Causes The reasons behind the autoimmune attacks are still unclear. Various family and twin studies, including a 2010 epidemiological study of patients with Graves' disease, have suggested that the disease has a hereditary component. Moreover, the likelihood of getting the disease is correlated to the number of affected family members. Shared lifestyle among family members seems to explain only a small proportion of familial Graves' disease, according to the study. Despite that, the same study also found a higher incidence of the disease occurring in both spouses, which suggests that there's a small likelihood that the disease is somewhat influenced by environmental conditions. In addition, the disease is also associated with 19 other autoimmune and related conditions, including Addison's disease, type 1 diabetes mellitus, Hashimoto/hypothyroidism, and lupus erythematosus. Pregnancy could also trigger Graves' disease. According to the National Women's Health Information Center , as many as 30 percent of young women who get Graves' disease have been pregnant in the 12 months prior to the onset of symptoms. Why? Pregnancy causes many different hormonal changes that stress the thyroid gland, including higher amounts of hormones that both stimulate and block the thyroid.

Diagnosis and tests First, a doctor will give a patient a physical exam to look for throat swelling, bulging eyes and other symptoms of Graves'. If Graves' disease is suspected and more tests are merited, the physician could order blood tests and thyroid scans to clarify the diagnosis. Blood tests measure the level of thyroid-stimulating hormone (TSH) and thyroxine. TSH is produced by the pituitary gland in the brain and normally regulates the level of thyroxine production. In Graves' disease, the autoimmune response creates thyroid-stimulating antibodies, which mimic the function of TSH. These are called TSI. TSI over stimulates the thyroid glands, making it produce more thyroxine than normal. Therefore, patients often have an elevated level of thyroxine even when TSH levels remain normal. People with Graves' disease typically have below average levels of TSH and higher levels of thyroid hormones, according to the Mayo Clinic. Also, patients who have hyperthyroidism caused by other conditions don't have these antibodies. During a thyroid scan, the patient takes a radioactive iodine tracer. The scan detects the location and intensity of the rays given off by the radioactive material within the gland, according to the NLM .

The distribution pattern helps to narrow down the type of thyroid disease, since the entire thyroid gland is involved in Graves' disease. Other causes of hyperthyroidism such as nodules, small lumps in the gland, show a different pattern of iodine distribution. Treatment and medication There are three treatment options: radioiodine therapy, antithyroid drugs and thyroid surgery. Radioiodine therapy is the most common treatment for Graves' disease in the United States, according to the National Endocrine and Metabolic Diseases Information Service . In radioiodine therapy, the patient ingests radioactive iodine-131. The thyroid gland collects iodine to make thyroid hormones, so, the radioactive iodine will end up in the thyroid gland. Once there, it will slowly destroy thyroid cells, allowing less thyroid hormone to be made. Often, the enough radioactive iodine is administered to shut down the thyroid gland completely. Normally, patients who take radioactive therapy will develop hypothyroidism (the exact opposite of hyperthyroidism) and must take synthetic thyroid hormone supplements, according to the National Endocrine and Metabolic Diseases Information Service. Radioiodine treatment is not offered to pregnant or breastfeeding women. The radioactive iodine can be harmful to the fetus' thyroid.

Even after birth, it can pass from mother to child through breast milk. Two antithyroid medications are available by prescription in the United States: Methimazole (brand name Tapazole) and Propylthiouracil (also known as PTU). Using the medications longer than one year often gives patients better long-term results, according to the Mayo Clinic. In certain cases, patients may opt for a thyroidectomy, or a complete removal of the thyroid gland. As with radioiodine therapy, patients need to take synthetic hormones after the surgery to compensate for the loss of thyroid function. Though risks are rare, surgery could potentially damage the vocal cords and parathyroid glands, which are the tiny glands located near the thyroid gland that produce a hormone that controls calcium levels in the blood, according to the Mayo Clinic . Prevention Although Graves' disease is not preventable, early detection can help patients seek treatment sooner. The American Association of Clinical Endocrinologists suggests regular "neck checks" to check for any bulges or protrusions around the neck when swallowing.

Additional resources Overactive thyroid (hyperthyroidism) - Causes - NHS Choices Overactive thyroid An overactive thyroid (hyperthyroidism) occurs when your thyroid gland produces too much of the thyroid hormones. This results in a high level of thyroid hormones called triiodothyronine (also called "T3") and thyroxine (also called "T4") in your body. The thyroid can become overactive for a number of reasons. Some of the main causes are described below. Graves' disease In about three in every four cases, an overactive thyroid is caused by a condition called Graves' disease. This is an autoimmune condition, which means the immune system mistakenly attacks the body. In Graves' disease, it attacks the thyroid and causes it to become overactive. The cause of Graves' disease is unknown, but it mostly affects young or middle-aged women and it often runs in families. Smoking can also increase your risk of getting it. Thyroid nodules Less commonly, an overactive thyroid can occur if lumps called nodules develop on the thyroid. These nodules are usually non-cancerous (benign), but they contain additional thyroid tissue, which can result in the production of excess thyroid hormones.

It's not known why some people develop thyroid nodules, but they most often affect people over 60 years of age. Medication An increased level of iodine in the body can cause the thyroid to produce excess thyroid hormones. This can occasionally occur if you're taking medication that contains iodine, such as amiodarone – a medicine sometimes used to control an irregular heartbeat (arrhythmia) . An overactive thyroid caused by medication will usually improve once the medication is stopped, although it may take several months for your thyroid hormone levels to return to normal.

Other causes Other possible causes of an overactive thyroid include: high levels of a substance called human chorionic gonadotrophin in the body – this can occur in early pregnancy, a multiple pregnancy or a molar pregnancy (where tissue remains in the womb after an unsuccessful pregnancy) a pituitary adenoma – a non-cancerous (benign) tumour of the pituitary gland (a gland located at the base of the brain that can affect the level of hormones produced by the thyroid) thyroiditis – inflammation of the thyroid, which can result in extra thyroid hormones being produced thyroid cancer – rarely, a cancerous thyroid tumour can affect the production of thyroid hormones Page last reviewed: 22/09/2016 Hyperthyroidism Lifestyle and home remedies - Mayo Clinic By Mayo Clinic Staff Once you begin treatment, symptoms of hyperthyroidism should subside and you should start feeling much better. The following suggestions also may help: Ask your doctor about supplementing your diet. If you've lost a great deal of weight or experienced muscle wasting, you may benefit from adding extra calories and protein to your diet. Your doctor or a dietitian can help you with meal planning.

In most cases, you won't need to continue supplementing your diet once your hyperthyroidism is under control. Treatment for hyperthyroidism can also eventually contribute to excessive weight gain. It is important to learn how to get as much nutrition as possible from your food without eating a lot of extra calories. In addition, eating the correct amount of sodium and calcium are important dietary considerations for people with hyperthyroidism. Get enough calcium and vitamin D. Because hyperthyroidism may contribute to thinning bones, it's important to get enough calcium every day to help prevent osteoporosis. The Institute of Medicine recommends 1,000 milligrams (mg) of calcium a day for adults ages 19 to 50 and men ages 51 to 70. That calcium recommendation increases to 1,200 mg a day if you're a woman age 51 or older or a man age 71 or older. The Institute of Medicine also recommends 600 international units (IUs) of vitamin D a day for adults ages 19 to 70 and 800 IUs a day for adults age 71 and older.

Talk to your doctor about appropriate dietary guidelines for you. Graves' disease If you have Graves' ophthalmopathy or dermopathy, the following suggestions may help soothe your eyes or skin: Apply cool compresses to your eyes. The extra moisture may provide relief. Wear sunglasses. When your eyes protrude, they're more vulnerable to ultraviolet rays and more sensitive to sunlight. Wearing sunglasses helps protect them from both sun and wind. Use lubricating eyedrops. Eyedrops may help relieve dryness and scratchiness. Be sure to use eyedrops that don't contain redness removers. Because your eyelids may not cover the entire eye when sleeping, a lubricating gel can be used before bed to prevent the cornea from drying out. Elevate the head of your bed. Keeping your head higher than the rest of your body may reduce swelling and may help relieve pressure on your eyes. Try over-the-counter creams for swollen skin. Over-the-counter creams containing hydrocortisone (Cortaid, others) may help relieve red, swollen skin on your shins and feet. For help finding these creams, talk to your pharmacist. AskMayoExpert. Hyperthyroidism.

Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2015. Ross DS. Diagnosis of hyperthyroidism. Accessed Sept. 11, 2015. Ross DS. Overview of the clinical manifestations of hyperthyroidism in adults. Accessed Sept. 11, 2015. Ross DS. Disorders that cause hyperthyroidism. Accessed Sept. 11, 2015. Hyperthyroidism. Merck Manual Professional Version. Accessed Sept. 11, 2015. Tintinalli JE, et al. Thyroid disorders: Hyperthyroidism and thyroid storm. In: Tintinalli's Emergency Medicine: A Comprehensive Study Guide. 7th ed. New York, N.Y.: The McGraw Hill Companies; 2011. Accessed Sept. 11, 2015. Hyperthyroidism. American Thyroid Association. Accessed Sept. 11, 2015. Graves' disease. National Institute of Diabetes and Digestive and Kidney Diseases. Accessed Sept. 11, 2015.

Dietary reference intakes for calcium and vitamin D. Institute of Medicine. Accessed July 17, 2012. Nippoldt TB (expert opinion). Mayo Clinic, Rochester, Minn. Sept. 18, 2015. Products and Services You & Your Hormones | Endocrine conditions | Graves' disease You & Your Hormones Email article to a friend | Last updated: January 16, 2015 Graves’ disease is autoimmune thyroid disease. The body produces antibodies against the thyroid gland causing it to become overactive, resulting in increased thyroid hormone production and hyperthyroidism. Alternative names for Graves’ disease Autoimmune hyperthyroidism . What is Graves’ disease? Graves’ disease is the name given to autoimmune thyroid disease. The thyroid gland is stimulated by autoantibodies which make it overactive, resulting in increased thyroid hormone production. Graves’ disease is named after the doctor who first described it, Robert Graves, and is the most common cause of hyperthyroidism. What causes Graves’ disease? The body reacts to the thyroid gland and produces special proteins (called antibodies) that attack the thyroid gland. This is called an autoimmune reaction.

These antibodies then stimulate the thyroid gland causing increased production and release of thyroid hormones. This reaction can be triggered by infection, stress or smoking. What are the signs and symptoms of Graves’ disease? These are the same for any kind of thyroid overactivity, irrespective of the cause. Common symptoms and signs include: palpitations (heart beating fast, occasionally irregularly) a sensation of feeling hot and excessive sweating weight loss although appetite is usually good (and sometimes better than normal) increased frequency of bowel movements muscle weakness and loss of muscle bulk a feeling of thirst and frequent urination difficulty in sleeping, restlessness, agitation and a change of behaviour periods may become irregular (usually becoming lighter) There may also be related swelling of the thyroid gland in the neck causing difficulty in swallowing and breathing. Graves’ disease can affect the eyes. They may become swollen and red, sometimes becoming more prominent and in severe cases, there may be double vision and squinting. This is called Graves’ ophthalmopathy or thyroid eye disease . See the article on thyoid eye disease for further information. There may be specific skin changes affecting the front of the legs, where the skin looks red and swollen. This is called Graves’ dermopathy or pretibial myxedema.

If left untreated, Graves’ disease can lead to heart failure. How common is Graves’ disease? Just over 1% of people suffer from an overactive thyroid gland from any cause. Women are five times more likely to suffer from it than men. Graves’ disease affects about 5 in 1,000 people. Like any autoimmune condition, Graves’ disease is more common in women than men. Is Graves’ disease inherited? Graves’ disease is not inherited. However, it has been seen to affect members of the same family. An identical twin is more likely to have Graves’ disease if the other twin is affected. Although there is a tendency for autoimmunity to be inherited, a mother cannot ‘pass on’ an overactive thyroid to her child. How is Graves’ disease diagnosed? The diagnosis happens in two parts: Overactivity of the thyroid gland can be assessed by a blood test to check thyroid function and measure the levels of thyroid hormones in the blood. This would include various combinations of thyroid stimulating hormone (the messenger hormone from the brain), free thyroxine and free tri-iodothyronine. Usually levels of thyroid stimulating hormone and free thyroxine are checked as a first step.

Graves’ disease can be confirmed by measuring thyroid antibodies (thyroid peroxidise or thyroid stimulating hormone receptor antibodies) or by a special scan of the thyroid called an isotope scan (this is different from an ultrasound scan). However, diagnosis is usually clear from the symptoms and on many occasions these additional tests may not be needed. Usually these tests are all done as an outpatient. How is Graves’ disease treated? Symptoms of thyrotoxicosis (high levels of thyroid hormones) can be treated with beta blockers (provided the patient can tolerate it). This is often the first type of treatment used. Although this can settle symptoms down, it does not affect the inflammation. Anti-thyroid drugs, carbimazole or propylthouracil, are used to treat the actual inflammation of the thyroid gland. Carbimazole is the first type of drug chosen and propylthouracil is usually used during pregnancy and breastfeeding. The duration of treatment is variable depending on the individual patient, ranging between 6 months to 24 months.

Some centres use a treatment regime called ‘block and replacement’, which involves ‘blocking’ the action of the thyroid gland completely with carbimazole and then ‘replacing’ the required thyroxine level with thyroid tablets. Alternatively, a titration regime may be used, where enough of the drug is given to partly suppress the thyroid gland and keep the body’s natural thyroid hormone levels within a normal range. Other kinds of treatment can be used once the acute thyrotoxicosis has settled. This could be in the form of surgery (to remove the gland) or radioiodine treatment (causes gradual destruction of the thyroid gland). There are pros and cons of both these methods and the specialist will discuss these with the patient. Some patients do not need surgery or radioiodine treatment as the tablets can settle down the inflammation adequately and the thyroid gland can function normally after that. Are there any side-effects to the treatment? Carbimazole can cause joint pain and an itchy rash. Most importantly, carbimazole can acutely reduce the white cell count in the body and thus reduces the body’s power to fight infections.

Should patients develop a fever, sore throat or become more unwell in any way they must contact their GP or be seen in the emergency department for a blood test to check the cell count. Although very rare, this complication can be fatal if the diagnosis is delayed. Propylthouracil, if used for a long time, can cause inflammation of blood vessels called vasculitis. This can affect all the organs. What are the longer-term implications of Graves’ disease? There will be a chance of Graves’ disease returning after one episode but the likelihood will reduce with time. Smoking can worsen thyroid eye disease associated with this condition, so it is important to stop immediately. Surgery, and in many cases radioiodine, will result in the thyroid becoming underactive, meaning that the patient will have to take thyroid hormone replacement (levothyroxine) for the rest of their life. The alternative to surgery or radioiodine is to take an anti-thyroid drug for a prolonged period of time (up to lifelong). The disadvantage of this approach is that patients can still have a flare of Graves’ disease. Graves' disease fact sheet | womenshealth.gov Graves' disease fact sheet What is Graves' disease?

Graves' disease is an autoimmune disease that affects the thyroid. The thyroid is a small gland in the front of the neck. It makes hormones called T3 and T4 that regulate how the body uses energy. Thyroid hormone levels are controlled by the pituitary, which is a pea-sized gland in the brain. It makes thyroid stimulating hormone (TSH), which triggers the thyroid to make thyroid hormone. With Graves' disease, the immune system makes antibodies that act like TSH, causing the thyroid to make more thyroid hormone than your body needs. This is called an overactive thyroid or hyperthyroidism. An overactive thyroid causes every function of the body to speed up, such as heart rate and the rate your body turns food into energy. Graves' disease is one cause of overactive thyroid. It is closely related to Hashimoto's disease, another autoimmune disease affecting the thyroid. Most people with Graves' disease have symptoms of an overactive thyroid, such as: Goiter (enlarged thyroid) Thinning of skin or fine, brittle hair Frequent bowel movements Lighter menstrual flow and less frequent periods Problems getting pregnant Unlike other causes of an overactive thyroid, Graves' disease also can cause: Eye changes.

For some people with Graves' disease, the tissue behind the eyes becomes inflamed and swells. This can cause bulging or discomfort in one or both eyes. Sometimes it affects vision. Eye symptoms can occur before, at the same time, or after other symptoms of Graves' disease begin. It may rarely occur in people with normal thyroid function. We do not know why these eye problems occur. They are more common in people who smoke, and smoking makes eye symptoms worse. Eye problems often get better without treatment. Reddening and thickening of the skin, often on the shins and tops of the feet. This rare skin problem is not serious and is usually painless. Most people with this skin problem also have eye problems from Graves' disease. Symptoms of Graves' disease can occur slowly or very suddenly and are sometimes confused with other health problems. Some people with Graves' disease do not have any symptoms. Who gets Graves' disease? Both men and women can get Graves' disease. But it affects women 10 times more often than men. Graves' disease occurs in people of all ages, but most often starts in the 20s and 30s.

People who get Graves' disease often have family members who have thyroid or other autoimmune diseases. People who get Graves' disease sometimes have other autoimmune diseases, such as: Vitiligo (vit-ihl-EYE-goh) — a disease that destroys the cells that give your skin its color Rheumatoid arthritis — a disease that affects the lining of the joints throughout the body Addison's disease — a disease that affects the adrenal glands, which make hormones that help your body respond to stress and regulate your blood pressure and water and salt balance Type 1 diabetes — a disease that causes blood sugar levels to be too high Pernicious (pur-NISH-uhss) anemia — a disease that keeps your body from absorbing vitamin B12 and making enough healthy red blood cells Lupus — a disease that can damage many parts of the body, such as the joints, skin, blood vessels, and other organs What causes Graves' disease? Many factors are thought to play a role in getting Graves' disease. These might include: Genes. Some people are prone to Graves' disease because of their genes. Researchers are working to find the gene or genes involved. Gender.

Sex hormones might play a role, and might explain why Graves' disease affects more women than men. Stress. Severe emotional stress or trauma might trigger the onset of Graves' disease in people who are prone to getting it. Pregnancy. Pregnancy affects the thyroid. As many as 30 percent of young women who get Graves' disease have been pregnant in the 12 months prior to the onset of symptoms. This suggests that pregnancy might trigger Graves' disease in some women. Infection. Infection might play a role in the onset of Graves' disease, but no studies have shown infection to directly cause Graves' disease. How do I find out if I have Graves' disease? Most people with Graves' disease have symptoms that are bothersome. If you have symptoms of Graves' disease, your doctor will do an exam and order one or more tests. Tests used to help find out if you have Graves' disease include: Thyroid function tests. A blood sample is sent to a lab to see if your body has the right amount of thyroid hormone (T4) and TSH. A high level of thyroid hormone in the blood plus a low level of TSH is a sign of overactive thyroid.

Sometimes, routine screening of thyroid function reveals mild overactive thyroid in a person without symptoms. In such cases, doctors might suggest treatment or watchful waiting to see if levels return to normal. Radioactive iodine uptake (RAIU). An RAIU tells how much iodine the thyroid takes up. The thyroid takes up iodine and uses it to make thyroid hormone. A high uptake suggests Graves' disease. This test can be helpful in ruling out other possible causes of overactive thyroid. Antibody tests. A blood sample is sent to a lab to look for antibodies that suggest Graves' disease. Graves'disease can be hard to diagnose during pregnancy because it has many of the same symptoms as normal pregnancy , like fatigue and heat intolerance. Also, some lab tests can be harder to interpret. Plus, doctors cannot use RAIU during pregnancy to rule out other causes. What could happen if Graves' disease is not treated? Without treatment, Graves' disease can lead to heart problems, weak and brittle bones, and even death. “Thyroid storm” is a very rare, life-threatening condition that can occur if overactive thyroid is not treated. An acute stress, such as trauma, surgery, or infection, usually triggers it to occur.

In pregnant women, untreated disease can threaten the mother and unborn baby's health. Does pregnancy affect the thyroid? Normal hormone changes during pregnancy cause thyroid hormone levels to increase. The thyroid also may enlarge slightly in healthy women during pregnancy, but not enough to be felt. These changes do not affect the pregnancy or unborn baby. Yet, untreated thyroid problems can threaten pregnancy and the growing baby. Symptoms of normal pregnancy, like fatigue and feeling hot, can make it easy to overlook thyroid problems in pregnancy. So if you have symptoms of overactive thyroid or notice a goiter, make sure to tell your doctor. Stillbirth Talk to your doctor about how to prepare for pregnancy or about birth control if you do not want to become pregnant. If you take antithyroid drugs and want to get pregnant, ask your doctor about treatment with radioactive iodine (RAI). Women treated with RAI at least 6 months before pregnancy don't need antithyroid drugs and can avoid exposing the unborn baby. If you have had RAI to treat Graves' disease, you should wait at least 6 months before getting pregnant. Your doctor also will need to watch your baby for thyroid-related problems that can occur later in the pregnancy. How is Graves' disease managed during pregnancy?

During pregnancy, you will need to see both your OB/GYN and an endocrinologist (en-doh-krih-NOL-uh-jist), a doctor who treats people with hormone problems. If you have had radioactive iodine (RAI) or surgery to treat Graves' disease in the past and become pregnant, tell your doctor. Your baby will need to be watched for thyroid-related problems that can occur later in the pregnancy. It is best to plan pregnancy so that Graves' disease is treated prior to conception. Pregnancy may cause changes in hormones that affect the thyroid, and thyroid problems can affect a growing baby. For some women with Graves' disease, symptoms worsen in the first trimester, and then improve for the rest of the pregnancy. Symptoms often worsen again after delivery. For these reasons, the treatment needs of pregnant women with Graves' disease often change, and an experienced doctor is needed to manage your treatment during and after pregnancy. Your doctor will check your thyroid hormone levels regularly. If antithyroid medicine is needed, PTU is usually prescribed in the first trimester, and MMI for the rest of the pregnancy. Thyroid surgery is rarely an option for pregnant women. And pregnant women cannot take RAI.

Beta-blockers are sometimes prescribed for short-term use during the first few weeks of pregnancy to relieve symptoms. Can I breastfeed if I am taking antithyroid medicine for Graves' disease? Many women who take antithyroid medicine choose to breastfeed. Only low amounts of these drugs cross into breast milk. Your doctor can help you weigh the benefits of breastfeeding with the possible risk of these drugs. This will help you decide what is best for you and your baby. Graves' Disease - Overactive Thyroid Gland Graves’ Ophthalmopathy (Eye Disease) What is Graves’ ophthalmopathy? Graves’ ophthalmopathy, also known as Graves’ eye disease, represents the most frequent non-thyroidal manifestation of Graves’ disease and is characterized by bulging eyes. Ophthalmopathy occurs in 50 percent of Graves’ cases with severe forms affecting 3 to 5 percent. Graves’ ophthalmopathy is more frequent in women than in men with a 1:4 male-to-female ratio; it is more common among cigarette smokers. Graves’ disease and Graves’ ophthalmopathy are chronic diseases with both physical and psychological symptoms ranging from no manifestations to severe manifestations. Why do the eyes bulge?

The tissues and muscles behind the eyes become inflamed and swell. Since the eye socket is inflexible and cannot accommodate the larger eyeball, the eye bulges out. This eye condition is caused by an abnormal increase of fat tissue within the orbital cavity as well as overdevelopment of the eye muscles. The result is not just bulging eyes, but headaches, pressure sensation, and tearing. In extreme cases, the pressure can cause optic neuropathy leading to a loss of vision. What are the symptoms of Graves’ ophthalmopathy? Common symptoms: Blindness How do you treat Graves’ ophthalmopathy? At its early, active stage, the disease can be treated with non-surgical therapies, such as corticosteroids. However, for those cases that do not respond to steroids or other conservative measures, The Institute for Advanced Reconstruction features a unique surgical solution with excellent results. Am I a surgical candidate? Once Graves’ ophthalmopathy becomes chronic, it is often resistant to conservative therapy. The response rate to nonsurgical treatments is about 65 percent and the results in most patients are modest. Even after successful immunosuppression, most patients have remaining eye changes and still require rehabilitative surgery.

Surgical intervention is indicated: in the event that conservative therapy fails during inactive stages of the disease as an emergency procedure in cases of acute optic nerve compression in patients with mild to moderate aesthetic impairment Patients presenting with Graves’ ophthalmopathy at The Institute for Advanced Reconstruction undergo a thorough evaluation to confirm the diagnosis. Advances in screening, including more sophisticated imaging (CT or MRI), now allow surgeons to evaluate Graves’ ophthalmopathy more accurately. In its more advanced stages, orbital decompression surgery, such as that performed by Dr. Tushar Patel of The Institute for Advanced Reconstruction, becomes necessary to reverse the effects of this condition. What is orbital decompression surgery? Orbital decompression surgery involves removing excess fat from the orbital cavity as well as expanding the orbital wall to alleviate pressure and congestion in and around the eyes. This will correct issues such as orbital congestion, pain, eye bulging, and eyelid disfigurement. In extreme cases, optic nerve damage, corneal breach, and eye dislocation are prevented. With Dr. Patel’s expertise, surgery may involve fat removal alone or include removal of bone to expand the orbital vault.

Surgery often involves a combination of these techniques, depending on the severity of the situation and the stage of the disease. One technique employed by Dr. Patel is transpalpebral orbital decompression. Dr. Patel is an expert in transpalpebral orbital decompression: a technique pioneered by famed plastic surgeon Dr. Neven Olivari of Germany. Orbital decompression, using the Olivari technique, underlines the importance in the role of fatty tissue in the evolution of the disease. Dr. Olivari first described transpalpebral orbital decompression surgery with the removal of intraorbital fat in 1988. The Olivari technique has been tested in more than 3,000 operations. From 1984 to 2004, a consecutive series of 1,635 patients (3,210 eyes) with Graves’ ophthalmopathy underwent this operation at Dr. Olivari’s institution in Germany (where Dr. Patel trained). In patients who are eligible for this procedure, this technique provides a more refined approach than previous surgical techniques that relied on bony decompression alone.

In one documented testimony, Brazilian surgeons who have written on their experience with the Olivari technique have concluded that surgical removal of orbital fat provides consistent improvement in appearance with a low rate of complications. How successful is orbital decompression surgery? The long-term postoperative results of the 1,374 patients studied are excellent. The majority of patients treated with transpalpebral orbital decompression had significant changes in functional and aesthetic outcomes. The majority of patients were satisfied with their cosmetic results and almost every patient showed a significant improvement in quality of life after surgical treatment. No patient developed a loss of visual sharpness. The conclusion of the study proved transpalpebral orbital decompression to be reliable, effective, and safe with long-lasting results in visual function as well as in the patient’s personal wellbeing. Related Articles

Question: In humans, Graves disease is the result of an overactive what?
Answer: Thyroid gland